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Risk factors for death or mechanical ventilation time after bidirectional cavopulmonary anastomosis in a developing country

Part of: Surgery

Published online by Cambridge University Press:  15 June 2021

Marina C. Jonas ,
Fabio Carmona ,
Luiz F. Caneo ,
Aida L. R. Turquetto ,
Marcelo B. Jatene  and
Paulo H. Manso Open the ORCID record for Paulo H. Manso [Opens in a new window]
Marina C. Jonas
Affiliation:
Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
Fabio Carmona
Affiliation:
Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
Luiz F. Caneo
Affiliation:
Division of Cardiovascular Surgery. Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
Aida L. R. Turquetto
Affiliation:
Division of Cardiovascular Surgery. Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
Marcelo B. Jatene
Affiliation:
Division of Cardiovascular Surgery. Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
Paulo H. Manso*
Affiliation:
Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
*
Author for correspondence: Paulo H. Manso, Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Avenida Bandeirantes 3900. Ribeirao Preto, SP 14049-900 Brazil. Tel: +55-16-39633017; Fax: +55 16 36022700. E-mail: phmanso@fmrp.uspbr
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Abstract

Background:

Glenn procedure is performed for patients with cyanotic CHD and univentricular physiology and has a survival rate above 90%.

Aim:

To evaluate the risk factors associated with a poor outcome after Glenn procedure.

Methods:

The data for this retrospective analysis were collected from a regional Brazilian registry of congenital heart surgeries (ASSIST initiative) from 2014 to 2019. Data from 97 patients who underwent the Glenn procedure were considered. The primary outcomes were prolonged mechanical ventilation (>24 hours post-operatively) or in-hospital death, alone and combined.

Results:

The overall in-hospital mortality was 13.4% (n = 13). Prolonged mechanical ventilation occurred in 52% (n = 51) of the patients. Our analysis found that risk factors for death or prolonged post-operative mechanical ventilation were cardiopulmonary bypass duration and post-operative lactate, whereas weight-for-age z-score and age at surgery were risk factors for prolonged mechanical ventilation. Cardiopulmonary bypass duration increased (adjusted odds ratio: 1.02; 95 % CI: 1.01, 1.03) and age at surgery decreased (adjusted odds ratio: 0.96; 95 % CI: 0.93, 0.99) the odds of the combined outcome.

Conclusions:

Age at surgery, post-operative lactate, and low-weight-for-age z-score are associated with prolonged mechanical ventilation and death following the Glenn procedure.

Keywords

Glenn procedurebidirectional cavopulmonary anastomosisrisk factorsCHD
Type
Original Article
Information
Cardiology in the Young , Volume 32 , Issue 3 , March 2022 , pp. 415 - 419
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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